Individual provider Active NPI

Christina Smith, D.D.S.

  • Pediatric Dentistry
  • Pembroke Pines, FL
National Provider Identifier
1104963149
Registry record updated May 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
17836 Issued in FL
Practice address
12301 Taft St
Suite 300
Pembroke Pines, FL 33026-4387
Phone
(953) 962-8311
Fax
(954) 435-1739
NPI assigned
Jan 31, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 17836 FL Primary
Pediatric Dentistry 1223P0221X 053087 NY

Addresses

Primary practice location

12301 Taft St
Suite 300
Pembroke Pines, FL 33026-4387

Mailing address

12301 Taft St
Suite 300
Pembroke Pines, FL 33026-4387
Phone (953) 962-8311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
17836FLMDPediatric Dentist
053087NYMDPediatric Dentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431561600000",
    "number": "1104963149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12301 TAFT ST",
            "address_2": "SUITE 300",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330264387",
            "telephone_number": "953-962-8311",
            "fax_number": "954-435-1739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12301 TAFT ST",
            "address_2": "SUITE 300",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330264387",
            "telephone_number": "953-962-8311",
            "fax_number": "954-435-1739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHRISTINA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2015-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "17836",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "053087",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.